Clinical Documentation Improvement Specialist

Health Choice Network

. Serve as a subject matter expert on ICD-10-CM Coding Guidelines, AHA Coding Clinic guidance, and Risk Adjustment methodologies .

Posted 11/5/2026full-timeRemote • United StatesMid-LevelSenior💰 $70,000 - $85,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in ICD-10-CM Coding Guidelines and Risk Adjustment methodologies, with a strong focus on documentation quality and coding accuracy. Capable of developing educational programs and collaborating with clinical teams to enhance value-based care initiatives.

Highest-signal resume keywords

ICD-10 CodingRisk Adjustment MethodologiesCertified Risk Coder (CRC)Clinical Documentation ReviewHCC Coding Expertise

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

ICD-10 CodingRisk Adjustment MethodologiesClinical Documentation ReviewHCC CodingMedical TerminologyAnatomyPhysiologyData AnalyticsDocumentation ImprovementQuality Score Improvement

Soft Skills

Analytical SkillsOrganizational SkillsProblem-Solving SkillsWritten CommunicationVerbal Communication

Tools & Technologies

Epic Electronic Medical Record (EMR) Systems

Certifications & Qualifications

Certified Risk Coder (CRC)Certified Professional Coder (CPC)CDI/CCS Certification

Industry Keywords

MedicareMedicaidValue-Based CarePopulation HealthFederally Qualified Health Center (FQHC)

About the role

Key responsibilities & impact

Serve as a subject matter expert on ICD-10-CM Coding Guidelines, AHA Coding Clinic guidance, and Risk Adjustment methodologies
Conduct proactive medical record reviews to evaluate documentation quality, diagnosis coding accuracy, co-morbidities, complications, and appropriate secondary diagnoses
Ensure patient conditions are accurately documented and coded to support quality care and appropriate risk stratification
Identify documentation and coding trends impacting patient risk scores and value-based care performance
Develop and deliver education programs for providers, coders, and clinical care teams
Provide guidance on documentation best practices, coding updates, compliance requirements, and risk adjustment principles
Create educational tools, resources, and training materials
Partner with providers to identify documentation improvement and workflow optimization opportunities
Collaborate with contracted health plans on risk adjustment and value-based care initiatives
Support auditing activities, review health plan findings, and develop performance improvement plans when needed
Participate in clinical quality, revenue cycle, population health, and data analytics initiatives
Monitor regulatory, coding, and reimbursement changes and communicate impacts across the organization
Analyze documentation and coding trends to identify improvement opportunities
Work closely with clinical leadership, coding teams, health plans, and operational stakeholders
Help drive strategies that improve quality scores, risk adjustment accuracy, and overall organizational performance

Requirements

What you’ll need

Associate degree required; Bachelor's degree preferred
Certified Risk Coder (CRC) through AAPC or CDI/CCS certification through AHIMA
Minimum of 3 years of experience in Medicare and/or Medicaid Risk Adjustment, including HHS-HCC, CMS-HCC, or DxCG methodologies
Strong experience with ICD-10 coding and clinical documentation review
In-depth knowledge of medical terminology, anatomy, physiology, and disease processes
Expertise in HCC coding and risk adjustment programs
Strong analytical, organizational, and problem-solving skills
Excellent written and verbal communication skills with the ability to educate audiences at all levels
Ability to manage multiple priorities and work independently in a remote environment
Current RN license in good standing (preferred)
Certified Professional Coder (CPC) through AAPC (preferred)
Minimum of 3 years of clinical experience, preferably in a Federally Qualified Health Center (FQHC) or primary care environment
Experience with Epic Electronic Medical Record (EMR) systems (preferred)
Experience supporting value-based care and population health initiatives (preferred)
Applicants must reside and perform work in an approved state at the time of hire and throughout employment
Health Choice Network is not able to employ individuals who reside or work in California

Benefits

Comp & perks

100% Remote Work – Work from anywhere within the United States
100% Employer-Paid Medical Insurance – Comprehensive medical coverage at no cost to employees on one of our health plans
Generous Paid Time Off (PTO)
403(b) Retirement Plan with Employer Contribution
Professional Development & Education Assistance – Ongoing learning, certifications, and educational opportunities
Mission-Driven Culture dedicated to strengthening community health and expanding access to quality healthcare services